Ugandan study shows hope to nevirapine option

By Henry Neondo

A British sponsored study for management of HIV disease in resource-limited setting in Uganda shows some hope over drug reaction associated with Nevirapine.

The study concurrently being done in Uganda and Zimbabwe sponsored by UK’s Department for International Development (DFID) and run by the UK’s Medical Research Council shows that Abacavir (Ziagen) appears to cause fewer serious adverse drug reactions than nevirapine in African patients taking part in a trial substudy according to investigator’s report at the 13 Conference on Retroviruses and Opportunistic Infections in Denver.

The substudy reported this week has recruited 600 patients to a comparison of abacavir or nevirapine in combination with AZT/3TC, dosed as Combivir.

According to presenter, Dr Paula Munderi, the primary endpoint of the study was the number of serious adverse drug reactions probably or uncertainly related to the study drug occurring in each arm.

There was also a lower rate of treatment discontinuation in the abacavir arm, and the observed rate of abacavir hypersensitivity was considerably lower than rates reported in Caucasian populations.

Distinguishing between abacavir and nevirapine hypersensitivity proved quite difficult, with considerable overlap of symptoms such as rash, fever and respiratory symptoms.

If abacavir proves to be non-inferior to nevirapine in this study, but with a lower rate of serious adverse events, it may prove an attractive alternative to nevirapine in resource-limited settings, particularly in women and TB patients.

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